My Stroke of Insight: A Brain Scientist's Personal Journey (9 page)

I was shocked, however, when I did realize that I could not speak intelligibly. Even though I could hear myself speak clearly within my mind,
This is Jill, I need help!,
the sounds coming out of my throat did not match the words in my brain. I was disturbed to comprehend that my left hemisphere was even more disabled than I had realized. Although my left hemisphere could not decipher the meaning of the words he spoke, my right hemisphere interpreted the soft tones in his voice to mean that he would get me help.

Finally, in that moment, I could relax. I didn't need to understand the details of what he would do. I knew that I had done all that I could do; all that anyone could have hoped that I would do, to save myself.

As I sat there in the silence of my mind, satisfied that Steve would get me help, I felt relieved that I had successfully orchestrated my rescue. My paralyzed arm was partially recovered and although it hurt, I felt hopeful that it would recover completely. Yet even in this discombobulated state, I felt a nagging obligation to contact my doctor. It was obvious that I would need emergency treatment that would probably be very expensive, and what a sad commentary that even in this disjointed mentality, I knew enough to be worried that my HMO might not cover my costs in the event that I went to the
wrong
health center for care.

Still sitting at my desk, with my good left arm I reached for the three-inch stack of business cards I had collected over the past few years. I had only visited my current doctor once, about 6 months earlier, but I remembered that there was something Irish about her name -St. something, St. something, so I began searching for associations. In my mind's eye, I could recall perfectly the symbol of the Harvard crest located in the top central position of her business card. Pleased with my ability to remember exactly what the card looked like, I thought to myself,
Fine, this will be just fine; all I have to do is find the card and make the call.

To my astonishment, however, as I looked at the top card, I realized that although I retained a clear image in my mind of what I was looking for, I could not discriminate any of the information on the card in front of me. My brain could no longer distinguish writing as writing, or symbols as symbols, or even background as background. Instead, the card looked like an abstract tapestry of pixels. The entire picture was a uniform blend of all its constituent pieces. The dots that formed the symbols of language blended in smoothly with the dots of the background. The distinctions of color and edge no longer registered to my brain.

Dismayed, I realized that my ability to interact with the external world had deteriorated far more than I could ever have imagined. My grip on normal reality had been all but peeled away. I was no longer capable of perceiving the mental cues I had depended on to visually discriminate between objects. On top of my inability to identify my own physical boundaries, and in the absence of my internal clock, I perceived myself as fluid. Coupled with my loss of long-term and short-term memories, I no longer felt grounded or safe in the external world.

What a daunting task it was to simply sit there in the center of my silent mind, holding that stack of cards and trying to remember,
Who am I? What am I doing?
Searching for any connection with my external reality, I had lost all sense of urgency. Yet amazingly, my frontal lobe fought hard to hang on to the task and I still embraced the occasional wave of clarity that routed me back into this earthly realm via my physical pain. During these moments of clarity, I could see, I could identify, I could remember what I was doing, and I could discriminate again between the varied incoming stimuli. So faithfully I plodded forward.
That's not the card, that's not the card, that's not the card.
It took over 35 minutes for me to navigate my way a mere inch down into that stack where I finally recognized the Harvard crest.

By this point, however, the entire concept of a telephone was a very interesting and bizarre kind of thing. I felt oddly removed from my ability to have any comprehension about what it was I was supposed to do with it. Somehow I understood that this "thing" in my space was going to connect me through a wire to a completely different space. And at the other end of the wire, there would be a person to whom I could speak and she would understand me. Wow, imagine that!

Because I was afraid that I would lose my focus and the doctor's card would get confused with the others, I cleared the desk space in front of me and placed her card directly in front. I picked up the phone and placed the number keypad on the desk right next to the business card. Because my brain had been on a steady rate of disintegration, the appearance of the number pad now looked completely strange and foreign. As I sat there drifting in and out of my insubordinate left mind, I remained calm. Periodically, I was able to match the number squiggle on the card to the number squiggle on the telephone keypad. To keep track of the numbers that I had already dialed, I covered the number on the business card with my left index finger as soon as I pushed the number on the phone using my stumpy right index finger. I had to do this because I could not remember from moment to moment which numbers I had already pressed. I repeated this strategy until all the numbers were dialed and then I placed the phone to my ear and listened.

Feeling drained and disoriented, I was afraid that I would forget what I was doing, so I continued to repeat in my mind,
This is Jill Taylor. I'm having a stroke. This is Jill Taylor. I'm having a stroke.
But when the phone was answered and I tried to speak, I was blown away to discover that although I could hear myself speaking clearly, within my mind, no sound came out of my throat. Not even the grunts that I was able to produce earlier. I was flabbergasted.
Oh my gosh! I can't talk, I can't talk!
And it wasn't until this moment when I tried to speak out loud that I had any idea that I couldn't. My vocal cords were inoperative and nothing, no sound at all, would come forth.

Like priming a pump, I pushed air forcefully out of my chest and inhaled deeply, over and over again, trying to make some sound, trying to make any sound come out. Realizing what I was doing, I thought,
They're going to think this is an obscene phone call! Don't hang up! Please don't hang up!
But just like priming a pump, repeatedly pushing the air in and out, forcing my chest and my throat to vibrate, "Uhhhhhh,    uhhhhhh,    thhhhhh,    thhhhhhe,

thhhhhiiiiiiizzzxzzaaaaaaa" finally came out. The call was immediately forwarded from the receptionist to my doctor, who miraculously just happened to be sitting in for office hours! With the patience of a gentle soul, she sat and she listened as I struggled to enunciate, "This is Jill Taylor. I'm having a stroke."

Eventually my doctor understood enough of my message to comprehend who I was and what I needed. She directed me, "Get to Mount Auburn Hospital." As she spoke, although I could hear her words, I could not grasp their meaning. Feeling despondent, I thought to myself,
If only she would speak more slowly and enunciate more clearly, perhaps I could get it, perhaps I could understand.
With hope in my heart, I pleaded in a semi-intelligible way, "Again?" With concern, she slowly repeated her directive, "Get to Mount Auburn Hospital." Yet again, I could not comprehend. With patience and genuine compassion for my obvious neurological breakdown, she repeated her directive. Repeatedly, I could not connect meaning to the sounds and make sense of what she said. Feeling exasperated by my own inability to understand her simple language, I primed my vocal pump again and somehow communicated that help was on its way and we would call her back.

At this point, it didn't take a brain scientist to understand what was going on in my brain. The longer the blood from the hemorrhage continued to spill into my cortex, the more massive the tissue damage would become and the more cognitively inept I would be. Although the AVM originally burst near the middle to posterior portion of my cerebral cortex in my left hemisphere, by this point, the cells in my left frontal lobe - responsible for my ability to generate language, were also compromised. It was predictable that as the blood interrupted the flow of information transmission between my two language centers (Broca's anteriorly and Wernicke's posteriorly, p. 40), I could neither create/express language nor understand it. At this point in time, however, my greatest concern was that my vocal cords were not responding to my mental cues. I still feared that the centers in the pons of my brainstem, including my center for inspiration, were possibly at risk.

Feeling defeated and tired, I hung up the phone. Rising from my seat, I wrapped a scarf around my head to block the streaming light from my eyes. Picturing the deadbolt on my front door, I slowly navigated my body, step by step, down the front flight of stairs by sliding on my butt. Ready for company and no longer preoccupied with what I felt compelled to do, I crawled back up the stairs to my living room, where I crouched on my couch to quiet my weary mind.

Despondent and alone, I felt discomfort in my pulsating head, and I communed with my wound as I acknowledged the degeneration of my connection to this life. With every moment that passed, I felt my connection with my body becoming weaker. I sensed that my energy was leaking out of this fragile container - deadening the distal tips of my fingers and toes. I could hear the machinery of my body grinding its wheels as my cells systematically manufactured my life, and I feared that my cognitive mind was becoming so disabled, so detached from its normal ability to function, that I would be rendered permanently disabled. For the first time in my life, I understood that I was not invincible. Unlike a computer that could be turned off and then rebooted, the richness of my life was completely dependent on not only the health of my cellular structure, but on the integrity of my brain's ability to electrically transmit and communicate its directives.

Humbled by the direness of my situation, I grieved for the loss of my life as I anticipated the death and degeneration of my cellular matrix. Despite the overwhelming presence of the engulfing bliss of my right mind, I fought desperately to hold on to whatever conscious connections I still retained in my left mind. By now, I understood clearly that I was no longer a normal human being. My consciousness no longer retained the discriminatory functions of my dominant analytical left brain. Without those inhibiting thoughts, I had stepped beyond my perception of myself as an individual. Without my left brain available to help me identify myself as a complex organism made up of multiple interdependent systems or to define me as a distinct collection of fragmented functions, my consciousness ventured unfettered into the peaceful bliss of my divine right mind.

As I sat in the silence and pondered my new perceptions, I wondered how disabled I could become before the loss would be permanent. I contemplated how many circuits I could lose and how detached from my higher cognitive abilities I could tread and still have any hope of ever regaining normal function. I hadn't come this far to just die or become mentally vegetative! So I held my head in my hands and wept. Amidst my tears, I clenched my fists and prayed. I prayed for peace in my heart. I prayed for peace in my mind and I prayed,
Please Great Spirit, don't shut down my life.
And into the silence my mind implored,
Hold on. Be still. Be quiet. Hold on.

I sat there in the middle of my living room for what seemed to be an eternity. When Steve appeared in the doorway, no words were exchanged. I handed him my doctor's card and he immediately called for instructions.

Promptly, he escorted me down the stairs and out the door. Gently, he guided me to his car, strapped me in, and reclined the seat. He wrapped my head with a scarf to shade my eyes from the light. He spoke softly, encouragingly patted my knee, and proceeded to drive to Mount Auburn Hospital.